The present invention relates generally to the patient sizing of compression garments for wound sites used during postoperative recovery, and more particularly, to a measuring strip article and method for sizing such garments on patients.
Medical procedures such as plastic, aesthetic, reconstructive, and like surgeries, and injuries such as burns, generally result in one or more wound areas on the operated upon or injured body part or parts. Wound and injury healing is a complex science affected by many inter-related body functions. Arterial and venous blood flows, lymphatic drainage and body temperature are three key factors in the reduction of the time for a wound or injury to heal without complications. Such complications can include edema, seroma, hematoma, and infection, to name a few, which inhibit proper wound healing and are sometimes life-threatening. Current post-operative procedures and devices used by medical professionals do not consider the simultaneous interaction of the above-mentioned blood flows, lymphatic drainage and maintenance of body temperature with wound or injury healing.
Arterial and venous blood flows are intricately related and regulated by the body. Flow pressure ranges are important and remain within certain parameters; changes to them can greatly affect body function as well as wound healing. Arterial pressures normally remain with 120 mm Hg (systolic) and 80 mm Hg (diastolic) and, due to the muscular nature and structure of the body""s arterial delivery system, remain relatively constant. On the other hand, venous pressures are more variable because veins are oftentimes compressed and consequently impede blood flow back to the heart. The central venous pressure is normally about 0 mm Hg while the venous resistance and the effect of hydrostatic pressure can vary the venous pressure up to about 100 mm Hg or more.
Key then to the continuous flow of arterial and venous blood flows is the venous pump. The veins are constantly being squeezed and compressed by the body""s muscles and other external pressures. It is important to note that the function of the venous system is extremely important to the circulatory filling pressure, an important determinant of cardiac output. The slightest improvement of venous tone and venous filling ultimately will positively affect cardiac output, which can be correlated to as an important factor to improved wound healing. External compression garments are commonly prescribed as an aid to a reduction in venous flows such as varicose veins.
The lymph system is an accessory route used by the body to maintain fluid balance between the interstitial spaces and the blood. Most of the fluid escaping from the capillaries is reabsorbed into the venous capillaries but the remaining 10%, or so, is key both to life function and wound healing. The lymph system, with this small amount of fluid, can also carry proteins and particulate matter away from tissue spaces (i.e., a wound site) that would not normally be removed by capillary action. The action of this function of the large vessel lymph system is called the lymphatic pump and is an intricate, fine functioning system of major lymph vessels and valves. Key to this is that the large lymph vessels can be compressed by the walls of the lymphatics themselves or by additional pressures from the surrounding surfaces. This same function in the large vessels occurs in the lymph capillaries.
During the normal postoperative period, the patient is restricted from activity, and is sometimes confined to a bed. This quiet period is contraindicated for the lymphatic pump action as there are no external factors to increase lymphatic flow during a time that the body most likely has need of such flow, for example, to reduce the occurrence of edema, seroma, hematoma and other complications. An externally applied compression would be helpful and advantageous to promote the beneficial lymphatic flow.
As mentioned above, the removal of proteins from the interstitial fluid has an important balancing effect. Proteins, in other than proper amounts, can affect tissue colloid osmotic pressures, which can affect capillary fluid absorption and interstitial fluid volumes and pressures. Interstitial fluid pressures are normally negative and are maintained this way by a proper functioning lymphatic pump but even more so by the removal of excess proteins. The area around the postoperative wound site has been most likely traumatized by a number of factors and thus the proper functioning if the wound site has been reduced. External compression can aid the body and more specifically lymphatic flows to maintain protein balances by maintaining the normal xe2x80x9cdryxe2x80x9d state of the interstitial spaces.
Common postoperative complications directly relating to interstitial fluid spaces include edema, seroma and hematoma, as noted hereinabove. Many factors can cause the interstitial pressures to increase and without a similar increase in fluid flows, there is a fluid buildup or edema. A stretch of the tissue spaces occurs with edemas of more than a few days, sometimes even a few hours, so proper and immediate treatment is important. Further to the stretch of the tissue is the fact that this excess fluid disrupts the normal absorption and use of tissue nutrients as the cells are now further from the capillaries. In the case of a wound site, this will slow the recuperative capacities of the body to heal the wound. Seromas can also affect the wound or injury site as does edema but, additionally, the danger of infection is increased. A hematoma similarly affects the wound site.
It should also be noted that arterial, venous and lymphatic pressures and flows are intricately balanced and interrelated. Additionally, the interstitial fluid volume and pressures are also balanced with these systems. The skin acts as the body""s normal enclosure and it has its own elastic characteristics. Injury or wounds may disrupt the normal fluid and pressure balances causing fluids to build up and the skin stretches or contracts depending on the time from injury.
It is possible to proactively address the possibility of complications by applying external pressure immediately postoperatively with the intent of increasing capillary pressures and lymphatic flows, with a target range of about 17 to 32 mm Hg above the normal capillary pressure. This can be done with a properly designed, sized and applied compression garment.
Compression garments such as elastic bandages, dressings, girdles, vests, facial bandages, arm bandages, surgical bras, briefs, body suits, gloves, leg bandages, and trunk bandages are commonly used in the treatment of these cases with generally favorable results. However, there are well-known cases of the use of such articles that due to their design, material composition, sizing or application actually worsened the patient condition and caused complications. The correct application of compression is critical to enable the garment to perform within the intricate requirements of the body""s systems as described hereinabove. A garment that is properly sized and applied performs as good or better than skin in stretch, compression, and thermoregulation, and is greatly beneficial in promoting proper and rapid healing in the patient""s postoperative regime.
Compression garments are typically made and sold in a fixed range of sizes, unless custom-made garments are required. Accurately fitting the user with a garment that is the correct size, to thereby provide the desired compression, elasticity, and moisture absorption, is problematic when exact measurements are requested. Typically, to size a compression garment, an attendant must precisely measure a body part in inches or centimeters, make a notation of the measurement, look up the measurement in a conversion chart to determine the appropriate garment size such as small, medium, large, etc., and finally, order the proper size garment from an inventory.
The possibility of human error is thus introduced into the process at two steps, when the attendant takes the measurement and, as a greater concern, when the attendant looks up the measurement in a conversion chart. The too common result of misreading the conversion chart is that an improperly sized garment is applied during early post-operative period which is most critical to the proper and speedy recuperation of the wound.
Furthermore, known conversion charts merely provide a cross-reference of a body part measurement to a garment size based on conventional garment sizes. For example, a waist measurement of 34xe2x80x3 is cross-referenced to a garment size of xe2x80x9cmedium.xe2x80x9d This methodology does not take into account the change in compression applied to an object as the stretch fabric is stretched around the object or the desired compression to be applied to a wound or burn site.
Compression garments are usually constructed of commercially available elastic/stretch fabrics and/or moisture-absorbing fabrics. One such fabric is described in U.S. patent application Ser. No. 09/127,208, filed Jul. 7, 1998, now U.S. Pat. No. 5,994,912, issued to Watkins. Stretch fabrics are commonly made of a spandex material such as LYCRA(copyright). Spandex is a complex, synthetic, elastomeric material with stretch up to 500-600% or more and is typically blended with other types of fibers such as polyesters, cottons, nylons and other commercially available materials. Along with these different fiber blends, different fabric construction methods can be used such as weaving and knitting. Within knitting, tricot and raschel constructions are commonly used. Additionally, there is a known stretch fabric that is constructed of similar fibers but manufactured into a web.
These fabrics perform in differing ways as they stretch across the body. As described hereinabove, it is important that the fabric""s compressive properties be correlated to the fabric""s stretch so that compression garments made of the stretch fabric can be properly sized. Known compression garment sizing articles or procedures do not adequately take into consideration these properties of stretch fabrics.
What is needed but not available in the prior art is a measuring article and method that provides for quick and accurate compression garment sizing to achieve the desired compression, elasticity, and moisture absorption at the wound site without having to make a precise numerical notation of a body part measurement or to refer to a conversion chart for proper garment sizing.
Generally described, the present invention provides a measuring article for determining a garment size from a measurement range of an object. The measuring article has a strip of material with a first end and a first surface. The first surface has at least one row of size indicia and size markers thereon. The size markers include a first size marker positioned a distance from the first end corresponding to the smallest measurement of the range of measurements, a last size marker positioned a distance from the first end corresponding to the largest measurement of the range of measurements, and at least one intermediate size marker positioned between the first marker and the last marker. Spaces are defined between the size markers, the spaces and the size marker positions corresponding to object measurement subranges correlated to the garment sizes. At least one size indicia designating the corresponding garment size is arranged within each of the spaces.
A first preferred embodiment of the present invention further provides a start marker on the first surface generally proximate the first end of the strip. At least one object indicia and at least one directional indicia are provided between the first end and the first size marker. Also, the strip has a second end, with at least one object indicia and at least one directional indicia provided between the last size marker and the second end. In an alternate first preferred embodiment, the size marker positions are adjusted to correlate the desired pressure to be applied to a wound or burn site to the elastic deformation of the garment material.
The size indicia are preferably a group of words, symbols, and/or abbreviations, such as but not limited to xe2x80x9cXXXSxe2x80x9d, xe2x80x9cXXSxe2x80x9d, xe2x80x9cXSxe2x80x9d, xe2x80x9cSxe2x80x9d, xe2x80x9cMxe2x80x9d, xe2x80x9cLxe2x80x9d, xe2x80x9cXLxe2x80x9d, xe2x80x9cXXXLxe2x80x9d, and xe2x80x9cXXXLxe2x80x9d or other size indicia systems, whether standard, customized, or unique. The object indicia are preferably selected from a group of words describing the garment or body part being measured, such as but not limited to xe2x80x9cneckxe2x80x9d, xe2x80x9cvestxe2x80x9d, xe2x80x9cbra chestxe2x80x9d, xe2x80x9carmxe2x80x9d, xe2x80x9cwaistxe2x80x9d, xe2x80x9chipsxe2x80x9d, xe2x80x9cthighxe2x80x9d, and xe2x80x9cbriefxe2x80x9d. The directional indicia are preferably provided by arrows, triangles, or other indicia.
The markers and indicia are preferably arranged in rows, with each row arranged for measuring a different body part for a certain garment type. Also, a second surface may have a plurality of size markers and size indicia thereon in an arrangement substantially the same as the size markers and the size indicia of the first surface. Thus, the measuring article may have four or more rows of markers and indicia on each of the two surfaces.
A second preferred embodiment of the present invention provides the measuring article of the first embodiment, with rows of markers and indicia starting at each end of the strip. A single measuring article of a given size can thus be used on more different body parts.
A third preferred embodiment of the present invention provides the measuring article of the first embodiment, with the strip made of an elastomeric material. The material is preferably selected to have an elasticity that is substantially the same as the elasticity of the garment material.
A method of determining a garment size for a body part provides the steps of wrapping a measuring article as described above generally around the body part, overlapping the first end or start marker of the measuring article with the garment size indicia between two garment size markers of the measuring article, reading the garment size indicia from the measuring article, and, entering the garment size indicia in a garment order system. The proper garment size for the body part is determined directly by use of the measuring article without the need to annotate a body part measurement or refer to a conversion chart for garment sizes.
The method may further include correlating a body part measurement to a garment size based upon a graph showing elasticity plotted against compression for stretch fabric. Also, the method may provide the step of determining an object indicia for the body part to be sized from a plurality of rows of different object indicia. Further, the method steps described above can be repeated for additional body parts.
Accordingly, it is an object of the present invention to provide a measuring article for quickly and easily sizing compression garments for body parts or other objects without the need to measure the body part, make a notation of the measurement, and refer to a conversion chart to obtain the corresponding garment size.
It is another object of the present invention to provide for accurate measuring of a body part and accurate sizing of a compression garment for the body part to thereby promote quick healing of a wound associated with the body part.
It is yet another object of the present invention to provide a measuring article that may be disposed after use for sterility purposes.
It is still another object of the present invention to provide for direct garment sizing for most any body part from a single measuring article.
It is a further object to provide a method of quickly and accurately measuring a body part and determining the appropriate size of a compression garment therefor.
These and other objects, features, and advantages of the present invention are discussed or apparent in the following detailed description of the invention, in conjunction with the accompanying drawings and the appended claims.